Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)

Andrea Necchi; Guru Sonpavde; Salvatore Lo Vullo; Daniele Giardiello; Aristotelis Bamias; Simon J Crabb; Lauren C Harshman; Joaquim Bellmunt; Ugo De Giorgi; Cora N Sternberg; Linda Cerbone; Sylvain Ladoire; Yu-Ning Wong; Evan Y Yu; Simon Chowdhury; Gunter Niegisch; Sandy Srinivas; Ulka N Vaishampayan; Sumanta K Pal; Neeraj Agarwal; Ajjai Alva; Jack Baniel; Ali-Reza Golshayan; Rafael Morales-Barrera; Daniel W Bowles; Matthew I Milowsky; Christine Theodore; Dominik R Berthold; Gedske Daugaard; Srikala S Sridhar; Thomas Powles; Jonathan E Rosenberg; Matthew D Galsky; Luigi Mariani; RISC Investigators

doi:10.1016/j.eururo.2016.09.042

Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)

Andrea Necchi, Guru Sonpavde, Salvatore Lo Vullo, Daniele Giardiello, Aristotelis Bamias, Simon J Crabb, Lauren C Harshman, Joaquim Bellmunt, Ugo De Giorgi, Cora N Sternberg, Linda Cerbone, Sylvain Ladoire, Yu-Ning Wong, Evan Y Yu, Simon Chowdhury, Gunter Niegisch, Sandy Srinivas, Ulka N Vaishampayan, Sumanta K Pal, Neeraj AgarwalAjjai Alva, Jack Baniel, Ali-Reza Golshayan, Rafael Morales-Barrera, Daniel W Bowles, Matthew I Milowsky, Christine Theodore, Dominik R Berthold, Gedske Daugaard, Srikala S Sridhar, Thomas Powles, Jonathan E Rosenberg, Matthew D Galsky, Luigi Mariani, RISC Investigators

Institut for Klinisk Medicin

39 Citationer (Scopus)

Abstract

Background The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. Objective To develop a new model based on real-world patients. Design, setting, and participants Individual patient-level data from 29 centers were collected, including metastatic UC and first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011. Intervention First-line, platinum-based, combination chemotherapy. Outcome measurements and statistical analysis The population was randomly split into a development and a validation cohort. Generalized boosted regression modelling was used to screen out irrelevant variables and address multivariable analyses. Two nomograms were built to estimate OS probability, the first based on baseline factors and platinum agent, the second incorporating objective response (OR). The performance of the above nomograms and that of other available models was assessed. We plotted decision curves to evaluate the clinical usefulness of the two nomograms. Results and limitations A total of 1020 patients were analyzed (development: 687, validation: 333). In a platinum-stratified Cox model, significant variables for OS were performance status (p < 0.001), white blood cell count (p = 0.013), body mass index (p = 0.003), ethnicity (p = 0.012), lung, liver, or bone metastases (p < 0.001), and prior perioperative chemotherapy (p = 0.012). The c-index was 0.660. The distribution of the nomogram scores was associated with OR (p < 0.001), and incorporating OR into the model further improved the c-index in the validation cohort (0.670). Conclusions We developed and validated two nomograms for OS to be used before and after completion of first-line chemotherapy for metastatic UC. Patient summary We proposed two models for estimating overall survival of patients with metastatic urothelial carcinoma receiving first-line, platinum-based chemotherapy. These nomograms have been developed on real-world patients who were treated outside of clinical trials and may be used irrespective of the chemotherapeutic platinum agent used.

Originalsprog	Engelsk
Tidsskrift	European Urology
Vol/bind	71
Udgave nummer	2
Sider (fra-til)	281-289
ISSN	0302-2838
DOI	https://doi.org/10.1016/j.eururo.2016.09.042
Status	Udgivet - 1 feb. 2017

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10.1016/j.eururo.2016.09.042

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Citationsformater

Necchi, A., Sonpavde, G., Lo Vullo, S., Giardiello, D., Bamias, A., Crabb, S. J., Harshman, L. C., Bellmunt, J., De Giorgi, U., Sternberg, C. N., Cerbone, L., Ladoire, S., Wong, Y.-N., Yu, E. Y., Chowdhury, S., Niegisch, G., Srinivas, S., Vaishampayan, U. N., Pal, S. K., ... RISC Investigators (2017). Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC). European Urology, 71(2), 281-289. https://doi.org/10.1016/j.eururo.2016.09.042

Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC). / Necchi, Andrea; Sonpavde, Guru; Lo Vullo, Salvatore et al.
I: European Urology, Bind 71, Nr. 2, 01.02.2017, s. 281-289.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Necchi, A, Sonpavde, G, Lo Vullo, S, Giardiello, D, Bamias, A, Crabb, SJ, Harshman, LC, Bellmunt, J, De Giorgi, U, Sternberg, CN, Cerbone, L, Ladoire, S, Wong, Y-N, Yu, EY, Chowdhury, S, Niegisch, G, Srinivas, S, Vaishampayan, UN, Pal, SK, Agarwal, N, Alva, A, Baniel, J, Golshayan, A-R, Morales-Barrera, R, Bowles, DW, Milowsky, MI, Theodore, C, Berthold, DR, Daugaard, G, Sridhar, SS, Powles, T, Rosenberg, JE, Galsky, MD, Mariani, L & RISC Investigators 2017, 'Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)', European Urology, bind 71, nr. 2, s. 281-289. https://doi.org/10.1016/j.eururo.2016.09.042

Necchi A, Sonpavde G, Lo Vullo S, Giardiello D, Bamias A, Crabb SJ et al. Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC). European Urology. 2017 feb. 1;71(2):281-289. doi: 10.1016/j.eururo.2016.09.042

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title = "Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy: Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)",

abstract = "Background The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. Objective To develop a new model based on real-world patients. Design, setting, and participants Individual patient-level data from 29 centers were collected, including metastatic UC and first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011. Intervention First-line, platinum-based, combination chemotherapy. Outcome measurements and statistical analysis The population was randomly split into a development and a validation cohort. Generalized boosted regression modelling was used to screen out irrelevant variables and address multivariable analyses. Two nomograms were built to estimate OS probability, the first based on baseline factors and platinum agent, the second incorporating objective response (OR). The performance of the above nomograms and that of other available models was assessed. We plotted decision curves to evaluate the clinical usefulness of the two nomograms. Results and limitations A total of 1020 patients were analyzed (development: 687, validation: 333). In a platinum-stratified Cox model, significant variables for OS were performance status (p < 0.001), white blood cell count (p = 0.013), body mass index (p = 0.003), ethnicity (p = 0.012), lung, liver, or bone metastases (p < 0.001), and prior perioperative chemotherapy (p = 0.012). The c-index was 0.660. The distribution of the nomogram scores was associated with OR (p < 0.001), and incorporating OR into the model further improved the c-index in the validation cohort (0.670). Conclusions We developed and validated two nomograms for OS to be used before and after completion of first-line chemotherapy for metastatic UC. Patient summary We proposed two models for estimating overall survival of patients with metastatic urothelial carcinoma receiving first-line, platinum-based chemotherapy. These nomograms have been developed on real-world patients who were treated outside of clinical trials and may be used irrespective of the chemotherapeutic platinum agent used.",

keywords = "Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carboplatin/administration & dosage, Carcinoma, Transitional Cell/drug therapy, Cisplatin/administration & dosage, Female, Humans, Internationality, Male, Middle Aged, Nomograms, Prognosis, Random Allocation, Retrospective Studies, Survival Analysis, Urologic Neoplasms/drug therapy",

author = "Andrea Necchi and Guru Sonpavde and {Lo Vullo}, Salvatore and Daniele Giardiello and Aristotelis Bamias and Crabb, {Simon J} and Harshman, {Lauren C} and Joaquim Bellmunt and {De Giorgi}, Ugo and Sternberg, {Cora N} and Linda Cerbone and Sylvain Ladoire and Yu-Ning Wong and Yu, {Evan Y} and Simon Chowdhury and Gunter Niegisch and Sandy Srinivas and Vaishampayan, {Ulka N} and Pal, {Sumanta K} and Neeraj Agarwal and Ajjai Alva and Jack Baniel and Ali-Reza Golshayan and Rafael Morales-Barrera and Bowles, {Daniel W} and Milowsky, {Matthew I} and Christine Theodore and Berthold, {Dominik R} and Gedske Daugaard and Sridhar, {Srikala S} and Thomas Powles and Rosenberg, {Jonathan E} and Galsky, {Matthew D} and Luigi Mariani and {RISC Investigators}",

year = "2017",

month = feb,

day = "1",

doi = "10.1016/j.eururo.2016.09.042",

language = "English",

volume = "71",

pages = "281--289",

journal = "European Urology",

issn = "0302-2838",

publisher = "Elsevier",

number = "2",

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TY - JOUR

T1 - Nomogram-based Prediction of Overall Survival in Patients with Metastatic Urothelial Carcinoma Receiving First-line Platinum-based Chemotherapy

T2 - Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC)

AU - Necchi, Andrea

AU - Sonpavde, Guru

AU - Lo Vullo, Salvatore

AU - Giardiello, Daniele

AU - Bamias, Aristotelis

AU - Crabb, Simon J

AU - Harshman, Lauren C

AU - Bellmunt, Joaquim

AU - De Giorgi, Ugo

AU - Sternberg, Cora N

AU - Cerbone, Linda

AU - Ladoire, Sylvain

AU - Wong, Yu-Ning

AU - Yu, Evan Y

AU - Chowdhury, Simon

AU - Niegisch, Gunter

AU - Srinivas, Sandy

AU - Vaishampayan, Ulka N

AU - Pal, Sumanta K

AU - Agarwal, Neeraj

AU - Alva, Ajjai

AU - Baniel, Jack

AU - Golshayan, Ali-Reza

AU - Morales-Barrera, Rafael

AU - Bowles, Daniel W

AU - Milowsky, Matthew I

AU - Theodore, Christine

AU - Berthold, Dominik R

AU - Daugaard, Gedske

AU - Sridhar, Srikala S

AU - Powles, Thomas

AU - Rosenberg, Jonathan E

AU - Galsky, Matthew D

AU - Mariani, Luigi

AU - RISC Investigators

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. Objective To develop a new model based on real-world patients. Design, setting, and participants Individual patient-level data from 29 centers were collected, including metastatic UC and first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011. Intervention First-line, platinum-based, combination chemotherapy. Outcome measurements and statistical analysis The population was randomly split into a development and a validation cohort. Generalized boosted regression modelling was used to screen out irrelevant variables and address multivariable analyses. Two nomograms were built to estimate OS probability, the first based on baseline factors and platinum agent, the second incorporating objective response (OR). The performance of the above nomograms and that of other available models was assessed. We plotted decision curves to evaluate the clinical usefulness of the two nomograms. Results and limitations A total of 1020 patients were analyzed (development: 687, validation: 333). In a platinum-stratified Cox model, significant variables for OS were performance status (p < 0.001), white blood cell count (p = 0.013), body mass index (p = 0.003), ethnicity (p = 0.012), lung, liver, or bone metastases (p < 0.001), and prior perioperative chemotherapy (p = 0.012). The c-index was 0.660. The distribution of the nomogram scores was associated with OR (p < 0.001), and incorporating OR into the model further improved the c-index in the validation cohort (0.670). Conclusions We developed and validated two nomograms for OS to be used before and after completion of first-line chemotherapy for metastatic UC. Patient summary We proposed two models for estimating overall survival of patients with metastatic urothelial carcinoma receiving first-line, platinum-based chemotherapy. These nomograms have been developed on real-world patients who were treated outside of clinical trials and may be used irrespective of the chemotherapeutic platinum agent used.

AB - Background The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. Objective To develop a new model based on real-world patients. Design, setting, and participants Individual patient-level data from 29 centers were collected, including metastatic UC and first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011. Intervention First-line, platinum-based, combination chemotherapy. Outcome measurements and statistical analysis The population was randomly split into a development and a validation cohort. Generalized boosted regression modelling was used to screen out irrelevant variables and address multivariable analyses. Two nomograms were built to estimate OS probability, the first based on baseline factors and platinum agent, the second incorporating objective response (OR). The performance of the above nomograms and that of other available models was assessed. We plotted decision curves to evaluate the clinical usefulness of the two nomograms. Results and limitations A total of 1020 patients were analyzed (development: 687, validation: 333). In a platinum-stratified Cox model, significant variables for OS were performance status (p < 0.001), white blood cell count (p = 0.013), body mass index (p = 0.003), ethnicity (p = 0.012), lung, liver, or bone metastases (p < 0.001), and prior perioperative chemotherapy (p = 0.012). The c-index was 0.660. The distribution of the nomogram scores was associated with OR (p < 0.001), and incorporating OR into the model further improved the c-index in the validation cohort (0.670). Conclusions We developed and validated two nomograms for OS to be used before and after completion of first-line chemotherapy for metastatic UC. Patient summary We proposed two models for estimating overall survival of patients with metastatic urothelial carcinoma receiving first-line, platinum-based chemotherapy. These nomograms have been developed on real-world patients who were treated outside of clinical trials and may be used irrespective of the chemotherapeutic platinum agent used.

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Carboplatin/administration & dosage

KW - Carcinoma, Transitional Cell/drug therapy

KW - Cisplatin/administration & dosage

KW - Female

KW - Humans

KW - Internationality

KW - Male

KW - Middle Aged

KW - Nomograms

KW - Prognosis

KW - Random Allocation

KW - Retrospective Studies

KW - Survival Analysis

KW - Urologic Neoplasms/drug therapy

U2 - 10.1016/j.eururo.2016.09.042

DO - 10.1016/j.eururo.2016.09.042

M3 - Journal article

C2 - 27726966

SN - 0302-2838

VL - 71

SP - 281

EP - 289

JO - European Urology

JF - European Urology

IS - 2

ER -